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v1.0.0
ICD-10 Guide
ICD-10 CodesO36.019

O36.019

Billable

Maternal care for anti-D [Rh] antibodies, unspecified trimester

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O36.019 is a billable code used to indicate a diagnosis of maternal care for anti-d [rh] antibodies, unspecified trimester.

Key Diagnostic Point:

Maternal care for anti-D [Rh] antibodies is crucial in managing pregnancies where the mother is Rh-negative and has developed antibodies against Rh-positive blood. This condition can lead to hemolytic disease of the fetus and newborn (HDFN), which can result in fetal problems such as anemia, jaundice, and even fetal distress. The management of this condition involves careful monitoring of the fetus's growth and well-being throughout the pregnancy. Ultrasound assessments are often performed to evaluate fetal growth and detect any signs of distress or complications. In cases of suspected fetal growth restriction, additional interventions may be necessary, including more frequent monitoring or early delivery if the risks to the fetus outweigh the benefits of continuing the pregnancy. The complexity of care increases with the presence of additional factors such as maternal health issues or previous pregnancies affected by Rh incompatibility. Therefore, thorough documentation of maternal and fetal assessments is essential for optimal care and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fetal response to maternal antibodies
  • Need for frequent monitoring and potential interventions
  • Documentation of maternal and fetal health status
  • Differentiation from other hemolytic conditions

Audit Risk Factors

  • Inadequate documentation of maternal antibody status
  • Failure to document fetal monitoring results
  • Misclassification of trimester leading to incorrect coding
  • Lack of clarity on interventions performed

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal antibody testing, fetal monitoring, and any interventions performed.

Common Clinical Scenarios

Routine monitoring of an Rh-negative mother with anti-D antibodies, management of fetal growth restriction due to hemolytic disease.

Billing Considerations

Ensure accurate documentation of fetal assessments and any complications that arise during the pregnancy.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal health history and fetal assessments.

Common Clinical Scenarios

Management of a high-risk pregnancy with anti-D antibodies, including potential transfusions or early delivery.

Billing Considerations

Focus on the implications of maternal-fetal blood group incompatibility and the need for specialized care.

Coding Guidelines

Inclusion Criteria

Use O36.019 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the trimester is accurately documented and that all relevant maternal and fetal conditions are coded appropriately

Exclusion Criteria

Do NOT use O36.019 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetrical care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care for a patient with anti-D antibodies.

Documentation Requirements

Complete records of all prenatal visits, assessments, and delivery details.

Specialty Considerations

Ensure that all aspects of care related to anti-D antibodies are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track and manage complications related to anti-D antibodies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track and manage complications related to anti-D antibodies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the ability to track and manage complications related to anti-D antibodies.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding O36.019?

Coding O36.019 is essential for tracking pregnancies affected by anti-D antibodies, which can lead to serious fetal complications. Accurate coding ensures appropriate management and monitoring of both maternal and fetal health.